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Prenatal acetaminophen exposure tied to greater ADHD risk in offspring

Prenatal exposure to acetaminophen was linked to an increased risk for ADHD in offspring, according to a nationwide study in Taiwan published in Journal of Clinical Psychiatry.

Although evidence has indicated a possible link between prenatal acetaminophen use and the offspring’s ADHD risk in white populations, whether this association exists in the Asian population remains largely unknown, Mu-Hong Chen, MD, PhD, from the department of psychiatry at Taipei Veterans General Hospital and National Yang-Ming University College of Medicine in Taiwan, and colleagues wrote.

The investigators identified 950 pairs of children with ADHD and their mothers as well as 3,800 matched control pairs between 1998 and 2008 from the Taiwan Longitudinal Health Insurance Database. They examined maternal acetaminophen use and gestational infections in the first, second and third trimester of pregnancy and from 3 months prior to pregnancy to the date of last period.

After adjusting for demographic data, gestational infections, comorbid perinatal conditions and maternal mental health disorders, Chen and colleagues found that acetaminophen exposure during both the first and second trimesters (OR = 1.28; 95% CI, 1-1.64), the second trimester (OR = 1.19; 95% CI, 1-1.4) or in any trimester (OR = 1.2; 95% CI, 1.01-1.42) was associated with a greater risk for ADHD in offspring.

Sensitivity analysis — which excluded gestational infections and maternal mental health disorders — confirmed these associations in the second trimester (OR = 1.33; 95% CI, 1.04-1.69) or in both the first and second trimesters (OR = 1.68; 95% CI, 1.18-2.4). In addition, sensitivity analysis revealed a link between maternal acetaminophen use in the first trimester and risk for ADHD in the child (OR = 1.27; 95% CI, 1-1.61).

“On the basis of our study results, clinicians and pregnant women are reminded that the prescription and use of acetaminophen must be carefully evaluated during pregnancy, especially in the first and second trimesters,” Chen and colleagues wrote. “Additional studies are necessary to clarify the definite pathophysiology of prenatal acetaminophen exposure and the offspring’s ADHD risk.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.